symfony lens and blurred vision

Hi Sue

Thank you for your response.

The surgeon recommended this op because implant lens' are much thinner than human ones and so the space created allows the angles to relax and the risk of glaucoma removed permanently. I did wear glasses for both reading and distance and so symphony was recommended to give a good range of vision.

I had no previous procedures done on my eyes.

The near vision stays clear for both reading and computer for both eyes but slightly better in first eye.

I am due to see the surgeon 4 weeks after second one was done.

Many thanks

Hi soks

yes I'm in the UK

Did you have the option for Zeiss LARA IoLs and if so why didn't you opt for them over the Symfony lenses. 

No, only the symphony was offered or a monfocal. I went with the recommendation of the surgeon who said this would give a good range of vision - he is also a bit surprised at the results and  thinks it is still early days and it might come good - or there are other options of laser surgery or fitting another lens on top - or wear glasses. 

I live in Brighton and had Toric Symfony lenses in both eyes, done at the Nuffield. It has been an utter disaster in my view. Like you I was convinced by the consultant that there was "a good chance" of being free of glasses. I understood there was a risk but I didn't consider the consequences of the risk. Looking at all the studies they seem to talk about "managing without glasses" and "only use glasses for some situations". It really is all too vague and meaningless. I need to wear glasses all the time and my vision is worse than it has ever been because of other problems caused by the operation. Symfony lenses should be banned and NICE do not recommend them.

Hi Alan, I'm sorry to hear about your experience. I also had my eyes done at the Nuffield inWoodingdean. I'm 54 and didn't have cateracts but had closed angle glaucoma which was the reason for the operation. I do need glasses for distance but they are a very weak prescription. I don't need them for reading or computer work or generally around the house. The glaucoma has gone and the pressure in my eyes is now normal and my eyes are healthy which is the main thing. The consultant said to do nothing for a year and then see where my vision ends up because any interventions carry risks. Do you need glasses for everything?

A neighbour obviously had the same but he just called it glaucoma and he had quite a difficult operation to relieve the pressure. He had a cataract operation some time later but I do not know the timescales.

I have worn glasses since about 14 with a period when I wore contact lenses but I gave up with those when I needed reading glasses. I’m still wearing glasses all the time after the operation. Distance is very good but with new glasses the extra sharpness is noticeable. I have haloes around lights but I do not drive so it is not important. But I also used photochromatic lenses to protect my eyes and so I was wearing sunglasses when I was out. It was a factor I should have considered and the consultant should have mentioned this. I need glasses for watching the TV which is blurred and I cannot read the text very well depending on size and colours. After the first operation and the lens had settled the TV was very clear without glasses. For TV my vision became worse after the second operation. I can read many things but it is blurred so only useful for looking at something quickly. After the first operation and the lens had settled I could read text on the phone with difficulty with that eye but now it is blurred. The eye seems to have got worse. In restaurants it is impossible to read menus in darker light without glasses and the second operation was supposed to improve reading. Managing is not my style, I want crisp vision and I don’t want to be carrying glasses around or have them on a chain. Now I have a huge number of floaters in my left eye, which disturbs the vision. It might be part the problem. I had my eyes checked for retina damage but there is no problem. The message is they might go away and/or the brain will learn to ignore them. That was two months ago and no change yet and the RNIB say it can take up to a year.

I found a RNIB document, “Understanding Cataracts” on their website. They say that the NHS does not used multifocal lenses because there is not enough evidence on how well they work.

There is also information on the NICE website, “Implantation of multifocal (non-accommodative) intraocular lenses during cataract surgery”. It was written in 2008 but updated in 2012. There is information from randomised control trials which says dependence on glasses is 68% for multifocal lenses and 95% for monofocal. Non-randomised trials which are not as reliable show that 92% of people with multifocal lenses do not need glasses. This is the information I was shown by the consultant but the results are biased and not as reliable as the RCT results. It is completely unacceptable to mislead patients in this way.

There is another NICE document “Cataracts in Adults: Management” published in 2017 which states “Do not offer multifocal intraocular lenses for people having cataract surgery” but it does not say why.

You can phone Moorfield Eye Hospital on 020 7566 2345 and speak to an ophthalmic nurse. I haven’t tried it.

Alan ,I was told that I wouldn't need glasses,but after the surgery ,the surgeon told me I would need glasses to get rid of the cloudiness.I did get new glasses ,but I still have cloudiness and my long distance is out of focus/blurry.The information I received from my family eye doctor and the surgeon sure mislead me to think it was a simple procedure ,which has being Hell since day one. I would have been better of not having the surgery,at that time I only needed reading glasses for up close and fine print. I guess it goes to say Live and Learn.

We believe that we can trust health professionals, but it seem that we cannot. One other thing is that there seems to be an obsession with not wanting to wear glasses. I don't understand it. I fell for it when I had cataract surgery because it seemed to make sense to pay a bit more and be glasses free. I'm convinced that my consultant gave me inappropriate data. The most accurate date is from randomised control trials and these show that 32% of people still need glasses. I was told that it is less than 10%. There is a big difference, and stupidly, I did not ask what sight problems the 10% have. We have learned to our cost that the problems are serious and do not seem to have a solution.

You might have cloudiness on the lens capsule which can be treated with a laser. I had that on one eye. The surgeon and optician should be able to detect this. There might also be issues with the condition of your cornea but your eye will feel uncomfortable. I also have that problem and I am using drops to lubricate the eye.

no surgeon should be promising glasses free no matter what type of lens you select. One can be less dependent on glasses depending on lens and outcome. power calculations aren't 100% accurate and IOLs come in .50 diopters not .25 like glasses so there is always the possibility one will still need glasses. These things should be properly discussed at consultation.

Now I know, but they claim that 90% of patients are glasses free. I do not believe that is correct and according to randomised control trials the figure is more like 68%. I have compared my sight to two people who had fixed focus lenses and it is more or less the same as mine with multifocus lenses. These lenses are just a waste of money. This is what one consultant says: "Accurate measurements before the operation allows us to precisely calculate the power of the artificial lens needed to focus the image on the retina."

As info even though the IOLs come in 0.5D the refractive difference is 0.35D only for a 0.5D lens difference.

I think people would still need glasses at night time for reading. Also I believe that Symfony offers correction for any 2 of the three distances (near,intermediate and far) for most people. Some people are fortunate and get all three. I compared myself with a coworker with monofocal lenses. I do not need glasses for computer. I need glasses for reading smaller print. He needs glasses for computer and stronger glasses for reading.

It would be nice if they knew how to calculate where you would end up with near/far and intermediate with each of the lens.

I have not read anything to suggest that Symfony lens only offer 2 out of 3 but I cannot see the point of having them. I know two people with fixed ficus lenses and without glasses they can manage to read the small text on my mobile which is how I view my sight. But even the TV is not clear without glasses. My right eye is the best but reading with my left eye is completely blurred, however I do have a mass of floaters that disturb my vision. Oddly with glasses I can read small text on the phone but larger text on an iPad is blurred.

Hi Alan - sorry to read about your frustration with Symfony lenses. Were you reading info on the net prior to surgeries or selected them based upon your surgeon's counsel?

My surgeries are now almost 18 months ago. Given I was blindsided by the cataract diagnosis at 53 I went on the net immediately to read up on the procedure and stumbled upon these forums. They were very helpful. I did go with Symfony lenses but due to info on the web and here knew I may not be glasses free for all 3 distances. My surgeon too was careful to explain the night vision compromise (although he did not specifically mention concentric circles - but thankful to a201 here on the forums I was aware of them). Surgeon also asked me questions about amount of reading I did and said I would need glasses for extended periods of reading and tiny print. Thankfully I rarely use glasses (novels newspapers and even pill bottles - although I need good lighting). I do reach for readers for some tiny print especially white lettering on colored backgrounds for some odd reason.

I live in Canada where this surgery like UK is covered - except NHS in UK will not implant anything but monofocal lenses. Here our surgeon's fees are covered and we can pay to upgrade our lenses. My Symfony lenses were $900 an eye. Surgeries are done in bulk so 25 people are all in waiting area with you having same surgery and back next day for check up. Following day we all compared our vision and I was only one able to read. Rest chose monofocal lenses. I don't doubt some may be able to read especially if 2nd eye was done for mini monovision where one eye is targeted for near. At the time of my surgery everyone in my group was having first surgery (right eye) done.

I do believe there are many variables that come into play - pupil size, power calculation astigmatism and other eye health issues that affects one's outcome. I don't think there ate bad or good lenses but not everyone will have same outcome.

It is such a big decision - affecting many aspects of our quality of life. These surgeries ate done without much thought or consideration to the patient. Like many things in life we can't rely on experts and have to do so much investigation and research and again go in hoping for the best but knowing there really is no guarantee.

If your eyes cannot be corrected even with glasses I suspect there is another issue going on. Do hope you are able to find the answers you need.

The surgeon was recommended by a friend who had monofocal lenses. He tried to convince her to have multifocal lenses but she could not understand what he was telling her. I only had a brief look on the internet to find out how multifocal lenses worked. I was told there was a slight risk of having to wear glasses but surgeon was optimistic. It was a case if having more money than sense and I thought it was worth a try. I don't even know the cause of my problem. I am sure there is some change to the left eye because it has got worse for reading but I do have a huge amount of floaters which disturb the vision and I might have a dry eye problem which is also a factor in poor vision. I'm using drops but no improvement. The standard response is that the eye will adjust. We are just left in limbo. The problem with the UK is free health care. It results in people just accepting what the NHS does and we don't investigate. But with private care I felt ad though I was paying for a top class service.

I hear you and if anything like a lot of private health - they have huge overhead and greedy for profit so you have to weed your way through that to find out if they are more about lining their pickets vs patient satisfaction.

I feel fortunate that Canada does pay for the surgery and surgeon gets same amount whether I opt for standard lens or premium lens. The additional expense for Symfony went to the hospital. But our system isn't perfect - long wait times. I been waiting 8 months to see ENT specialist and told wait for that is 18 months. Very discouraging.